Hematology

Question 1

Parovirus B19

Answer 1

• also called fifth disease, or erythema infectiosum
• characterized by slapped cheeks
• transient asymptotic reticulocytopenia
• can cause pure red blood cell aplasia (giant proerythroblast in the bone marrow biopsy) > IV Ig if immunocompromised

Question 2

CKD on dialysis, Anemic, when to start ESA as treatment for their anemia?

Answer 2

HG <10
Stop or reduce dose once HG >11 to avoid CVs risk

Question 3

Hereditary Spherocytosis mode of inheritance

Answer 3

Autosomal Dominant

Question 4

Hereditary Spherocytosis test of choice

Answer 4

Osmotic fragility test

Question 5

Hereditary spherocytosis picute

Answer 5

• Jaundice
• Splenomegaly
• Anemia
• can be distinguished from Autoimmune spherocytosis by coomb test

Question 6

Spherocytosis treatment

Answer 6

• Splenectomy can cure chromic hemolytic anemia due to hereditary Spherocytosis
• usually delayed as possible specially in childrens to avoid risk of sepsis
• Chronic hyperbilirubinemia due to hemolysis usually cause gallstones

Question 7

Transfusion indication in cancer patient

Answer 7

1- Symptomatic: HG <10
2- Asymptomatic: HG 7-8

ESA avoided in cancer due to concerns of tumor growth and thrombosis, it also doesn’t immediately raise HG making them less effective for symptoms relieve

Question 8

IDA in early stage

Answer 8

Normocytic

Question 9

IDA after iron replacement and reticulctyes

Answer 9

Reticulocytes response in 5-7 days

Question 10

5 vaccinces in SCA patients?

Answer 10

1- Pneumococcal
2- Meningococcal
3- HiB
4- Infleunza
5- Hepatitis B

Question 11

Pencillin v prophylaxis if SCA patients age?

Answer 11

3 months to 5 years

• 3m to 3y: 125mg BID
• 3y to 5y: 250mg BID